Sunday, December 15, 2013

Same question, plus a bit more. What's the general consensus of neutral experts going to be by, oh, the end of March on how the ACA is working? Series of disasters? Surprisingly successful, given the fiasco in October? Too soon to know? Or something else?

And what of Barack Obama's job in implementing the law. Presumably he'll still be knocked for October, but among liberals, will it look not so bad in retrospect? Sign of all that is wrong with his presidency? Demonstration that he makes at least his share of mistakes, but is good at recovering from them? Or something else?

17 comments:

People are getting a lot of surprises out of those 2000 pages and I am not sure they can fix it by a website that works. This either has to offer insurance at rates people can afford or it'll be considered another way to reward business. I have no idea how it'll be but it isn't looking good. Right now insurance corps make too much profit to hope it'll be good for individuals. It's one of Obama's problems to help the business community and also the workers. I don't think he's figured it out if he even cares.

I think by March the web site will be working well, and the law as a whole reasonably well. I think the biggest concern will be the mix of people in the exchanges. Not sure what is meant by a neutral expert. But I think the negative public and media perception of the law will continue to linger. Stories of people having problems with the law will continue to be overrepresented, because of media biases toward controversy and toward a big business point of view. Republicans will continue to fan the flames.

I think the humorous meta-question here is asking two partisan groups (Sunday question for liberals/conservatives) what "neutral" experts will say. I strongly suspect the two groups would expect that "neutral" experts would say what the respondents would say.

To conservatives, there is no such thing as neutrality-- any organization, any institution that is not explicitly conservative is liberal or will eventually become so. (If you think I am caricaturing, google "O'Sullivan's law.")

In political terms, March is a long way off, but it's striking to me how quickly the website problems have already more or less disappeared from my news feed. Just based on that, I would guess that the general CW by March will be that the exchanges are a "qualified success."

Political writers will probably be saying that the website problems prove the entire policy is completely unworkable and that the whole law is a total catastrophe that has destroyed the Obama Presidency, the Democratic Party, and liberalism in general for all time. At least they will be saying this for a while.

Policy wonks by and large will probably say that the law works quite well. It has already improved the lot of the 8 out of ten Americans who get their health care via employment or government programs, and it is getting health care to a lot of the three out of twenty people who don't have it. It's hard to see how any serious policy person can take the website problems (that by and large have been fixed) relating to the five percent of people who buy individual insurance policies and see them as some sort of indictment of the whole policy.

In terms of Obama I'd say that while the problems are obviously "on him" as he'd say, they strike me as being part of larger trends of political dysfunction. When you govern from Republican created crisis to Republican created crisis things like website creation can slip between the cracks. And when one of America's two great political parties has dedicated itself to sabotaging the law and denying healthcare to millions of Americans you'll have problems. I don't know if this will come through in the historical record, but I'd like to think some people will point this out in four months.

An AP poll showed 3 out of 4 were critical of ACA, mostly for bogus reasons: because premiums on their insurance were going up (as they always do) and coverage more restricted (a trend that predated ACA) etc. Some people didn't even understand the intent of the law for the uninsured, or that the law makes up the difference between what people can afford and the cost.

I expect Rs to keep the misinformation machine at a high pitch until November. It will be at particularly high pitch in March for primaries. So politically it won't much matter what "neutral" experts say, if (as many have commented) any such exist.

It should be added however that despite years of the same kind of misinformation the Rs fomented against Social Security in the 40s, they got nowhere. Whether that's because they trusted FDR so much or because the law evidently worked for people is beyond my knowledge. But here in twitterville, intense and well financed Internet gab probably trumps even personal experience let alone perspective, even as far far off as March is. If they can keep the mood negative, then everything can be blamed on ACA, scapegoat of the year.

The problem i see is how many people will have to pay more. We are on medicare and because of a withdrawal in 2012 to loan our kids money to buy a lake cabin, which they will pay us back, we got notified last week that our Medicare rate will double for 2014. That's based on one unusual year's income. A lot of old folks are finding surprises they don't like as they are forced to withdraw a percentage from the IRAs and basically are pushed into an upper income level which will double or more their insurance premiums. That's the kind of surprises that will hurt the dems in 2014. that 2000 page document had a lot of surprises built in. Incidentally I still favor health care for all but bet if it happens, a lot of us will find we are paying a LOT more for our insurance and we are mandated to buy it. It can end up with dems losing more seats and that could make a really nasty last two years for obama.

I don't even see it as unfair, Jeff... except it's based on one year. This isn't actual income which the year before or even the current one would show. Generally people get to average income over several years to show actual. And there was an article I found on it when I went looking for more than the one letter from SS. There were changes put into Medicare as a way to pay for the whole program. What was asked here though is how will it be seen and that's what I am talking about. IF the insurance corporations maintain their record profits, and families that don't consider themselves rich pay more, how do you think that will play out in the elections? What Obama has to worry about is 2014 and not finding himself with Republicans controlling Congress and having the ability to impeach. As I said, I still favor medicare for all BUT a lot of folks, who make what they consider to be average incomes will pay more to do it. The argument was ACA would make it cheaper for people to get health care and it might but it has some weird things written into it-- like people living in a resort area getting higher rates than before based on the tourists' incomes who also come there. It isn't by any means just about the website for whether it will fare well in the mid-terms or won't.

IF the insurance corporations maintain their record profits, and families that don't consider themselves rich pay more, how do you think that will play out in the elections?

If that happened on a large scale, that would be bad for Obama and the Democrats, but I don't believe it will. Many Medicare recipients will benefit from ACA-related changes, and those likely to be paying more are a small subset of the Medicare population, which in turn is a subset of the overall population:

Plus, even some of those who are paying these costs will still vote Democratic because they're Democrats, or lean that way, and support the ACA as a matter of principle. So this doesn't strike me as a big worry if, in other respects, the system is operating well next year.

I think that come March, a lot of older rural folks who were previously paying over a thousand a month for health insurance will be buying some nice new things, because their health insurance will be heavily subsidized by the government and will be saving them $600-$800 a month.

This will provide a small uptick in economic activity in these areas. Few neutral observers will make the connection.